Efficacy of Bisphosphonates in Reducing Fracture Risk in Postmenopausal Osteoporosis
Efficacy of Bisphosphonates in Reducing Fracture Risk in Postmenopausal Osteoporosis
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DOI：
10.1016/j.amjmed.2008.12.003
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发表时间：
2009-02-01
影响因子：
5.9
通讯作者：
Bilezikian, John P.
中科院分区：
文献类型：
--
作者：
Bilezikian, John P.
双膦酸盐已经有十多年的历史。目前，4种双膦酸盐-阿仑膦酸盐、利塞膦酸盐、伊班膦酸盐和唑来膦酸-在美国获得批准。阿仑膦酸盐和利塞膦酸盐是口服药物，伊班膦酸盐有口服和静脉制剂，唑来膦酸是静脉药物。这篇综述总结了这些双磷酸盐类药物已被证明可以降低骨质疏松性骨折风险的关键临床试验结果。还审查了“桥接”研究的结果，旨在证明较低频率的给药方案，以增加骨密度和减少骨转换的可比疗效。与安慰剂对照组相比，所有4种获批的双膦酸盐均降低绝经后骨质疏松症女性新发椎骨骨折的相对风险。阿仑膦酸钠、利塞膦酸钠和唑来膦酸可降低新发非脊椎和髋部骨折的相对风险。阿仑膦酸钠长达10年和利塞膦酸钠长达7年的临床试验扩展表明，在长期治疗期间维持疗效。(C)2009 Elsevier Inc. All rights reserved.美国医学杂志（2009）122，S14-S21
Bisphosphonates have been available for more than a decade. Currently, 4 bisphosphonates-alendronate, risedronate, ibandronate, and zoledronic acid-are approved in the United States. Alendronate and risedronate are oral agents, ibandronate is available in oral and intravenous formulations, and zoledronic acid is an intravenous drug. This review summarizes results from pivotal clinical trials in which these bisphosphonates have been shown to reduce risk for osteoporotic fractures. Also reviewed are results of "bridging" studies designed to demonstrate the comparable efficacy of less frequent dosing regimens to increase bone mineral density and to reduce bone turnover. Compared with placebo controls, all 4 approved bisphosphonates reduce the relative risk of new vertebral fractures in women with postmenopausal osteoporosis. Alendronate, risedronate, and zoledronic acid reduce the relative risk of new nonvertebral and hip fractures. Clinical trial extensions of up to 10 years with alendronate and 7 years with risedronate have shown that efficacy is maintained during long-term treatment. (C) 2009 Elsevier Inc. All rights reserved. The American Journal of Medicine (2009) 122, S14-S21